Effects of fascial manipulation, vibration exercise, motor imagery, or neuro-muscular electrical stimulation on the coagulation system: A pilot study

Available evidence suggests that various medical/rehabilitation treatments evoke multiple effects on blood hemostasis. It was therefore the aim of our study to examine whether fascial manipulation, vibration exercise, motor imagery, or neuro-muscular electrical stimulation can activate the coagulation system, and, thereby, expose patients to thrombotic risk. Ten healthy young subject were enrolled in the study. Blood samples were obtained pre and posttreatment. Besides standard laboratory methods, calibrated automated thrombography (CAT) and thrombelastometry (TEM) were used allowing sensitive detection of hyper- and hypocoagulable states. Application of fascial manipulation, motor imagery, or neuro-muscular electrical stimulation had vitually no effect whereas a single bout of vibration exercise caused significant coagulation activation. For example, TEM-derived coagulation times were significantly shortened (209 ± 34 vs. 187 ± 41 s, p = 0.0098) and CAT-derived thrombin peaks were significantly higher (235 ± 88 vs. 268 ± 82 nM, p = 0.0020) in post compared with preexercise samples. Moreover, vibration exercise, motor imagery, and neuro-muscular electrical stimulation caused significant plasma expansion (6.15%, 7.53%, and 3.88% plasma volume changes, respectively). We conclude that vibrational exercise apparently represents a potential procoagulant stimulus, and ongoing studies have to clarify whether VE should be applied particularly to patients with an elevated risk for thrombosis.